Universidade Estadual de Campinas, Faculty of Medical Sciences, Department of Surgery and Gastrocenter, Digestive Diseases Surgical Unit - Campinas (SP), Brazil.
Arq Bras Cir Dig. 2023 Jan 9;35:e1705. doi: 10.1590/0102-672020220002e1705. eCollection 2023.
Caustic ingestion is still a health problem of utmost importance in the West. In developing countries, this incident remains at increase and it is associated with unfavorable factors like social, economic, and educational handicaps, besides a lack of prevention. Esophagocele is a rare consequence of caustic ingestion.
We aimed to describe a patient with multiple caustic ingestions who presented an esophagocele resected by videothoracoscopy.
A woman ingested caustic soda when she was only 17 years old in a suicidal attempt during a depressive crisis. Initially, she was submitted to a retrosternal esophagocoloplasty with the maintenance of her damaged esophagus. After 1 year of this first surgery, she ingested caustic soda again in a new suicidal attempt. Her transposed large bowel in the first surgery became narrow, being replaced in a second surgery by a retrosternal esophagogastroplasty. Still, at the second surgery, her damaged esophagus remained in its original position in the posterior mediastinum. However, after 5 years, she developed an esophagocele.
The esophagocele was resected through videothoracoscopy in a prone position, employing four trocars. The postoperative was uneventful.
Esophageal exclusion must always be recorded because esophagocele presents unspecific symptoms. The videothoracoscopy in a prone position is an excellent technical option to resect esophagoceles.
腐蚀性摄入物仍然是西方国家一个极其重要的健康问题。在发展中国家，此类事件仍在不断增加，且与社会、经济和教育障碍等不利因素有关，此外还缺乏预防措施。食管憩室是腐蚀性摄入物的罕见后果。
我们旨在描述一位因多次腐蚀性摄入而接受胸腔镜切除食管憩室的患者。
一名女性在 17 岁时因抑郁发作而试图自杀时摄入了腐蚀性苏打水。最初，她接受了胸骨后食管结肠吻合术，以保留受损的食管。第一次手术后 1 年，她再次因试图自杀而摄入腐蚀性苏打水。第一次手术中转位的大肠变窄，在第二次手术中被胸骨后食管胃吻合术取代。尽管如此，在第二次手术中，她受损的食管仍位于后纵隔的原始位置。然而，5 年后，她出现了食管憩室。
通过在俯卧位使用四个套管进行胸腔镜切除术切除了食管憩室，术后无并发症。
必须始终记录食管的排除情况，因为食管憩室的症状不具特异性。在俯卧位进行胸腔镜手术是切除食管憩室的绝佳技术选择。
